Performance of Quantitative Ultrasound and Six Osteoporosis Risk Indexes in Menopausal Women: Validation and Comparative Evaluation Study
PDF

Keywords

Oporosis
Dual x-ray absorptiometry
Quantitative ultrasound
Risk indexes

Categories

How to Cite

1.
Ghozlani I, Mounach A, Ghazi M, Niamane R, El Maghraoui A. Performance of Quantitative Ultrasound and Six Osteoporosis Risk Indexes in Menopausal Women: Validation and Comparative Evaluation Study. Integr J Med Sci [Internet]. 2016 Jan. 30 [cited 2024 Jul. 24];3:40-6. Available from: https://mbmj.org/index.php/ijms/article/view/41

Abstract

Background: A number of questionnaire-based systems and the use of portable quantitative ultrasound scanners (QUS) have been devised in an attempt to produce a cost-effective method of screening for osteoporosis.
Objective: to assess the sensitivity and specificity of different techniques and their ability to act as screening tools in relation to dual-energy X-ray absorptiometry (DXA).
Methods: 295 white postmenopausal women aged over 60 were enrolled. Each subject completed a standardized questionnaire that permits the measurement of six osteoporosis indexes and had bone mineral density (BMD) measured using QUS and DXA. Sensitivity and specificity of the different techniques in relation to DXA were plotted as receiver-operating characteristic (ROC) curves at DXA T-score total hip ≤ -2.5 (osteoporosis).
Results: BUA sensitivity and specificity values were respectively 76.8% and 51.2% at the total hip. The optimal cut-off T-score for QUS was -2 at the total hip. The osteoporosis self-assessment tool (OST) provided consistently the highest AUC (0.80) among the clinical tools and had the best sensitivity and specificity balance (90.2%-44.5%). OST negative likelihood ratio was 0.22.
Conclusion: OST (based only on weight and age) performed slightly better than QUS and other risk questionnaires in predicting low BMD at the total hip.

https://doi.org/10.15342/ijms.v3i2.111
PDF

References

Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002 Jun 1; 359(9321):1929-36. https://doi.org/10.1016/s0140-6736(02)08761-5

Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res. 2005 Jul; 20(7):1185-94. https://doi.org/10.1359/jbmr.050304

El Maghraoui A, Koumba BA, Jroundi I, Achemlal L, Bezza A, Tazi MA. Epidemiology of hip fractures in 2002 in Rabat, Morocco. Osteoporos Int. 2005 Jun; 16(6):597-602. https://doi.org/10.1007/s00198-004-1729-8

Lu C, Chen D, Cai Y, Wei S. Concordane of OSTA and lumbar spine BMD by DXA in identifying risk of osteoporosis. J Orthop Surg Res. 2006 Nov 21; 1:14. https://doi.org/10.1186/1749-799x-1-14

Cook RB, Collins D, Tucker J, Zioupos P. Comparison of questionnaire and quantitative ultrasound techniques as screening tools for DXA. Osteoporos Int. 2005 Dec; 16(12):1565-75. https://doi.org/10.1007/s00198-005-1864-x

Park HM, Sedrine WB, Reginster JY, Ross PD, OSTA. Korean experience with the OSTA risk index for osteoporosis: a validation study. J Clin Densitom. 2003; 6(3):247-50. https://doi.org/10.1385/jcd:6:3:247

Salaffi F, Silveri F, Stancati A, Grassi W. Development and validation of the osteoporosis prescreening risk assessment (OPERA) tool to facilitate identification of women likely to have low bone density. Clin Rheumatol. 2005 Jun; 24(3):203-11. https://doi.org/10.1007/s10067-004-1014-4

Ghazi M, Mounach A, Nouijai A, Ghozlani I, Bennani L, Achemlal L, et al. Performance of the osteoporosis risk assessment tool in Moroccan men. Clin Rheumatol. 2007 Dec; 26(12):2037-41.https://doi.org/10.1007/s10067-007-0611-4

Gnudi S, Sitta E. Clinical risk factor evaluation to defer postmenopausal women from bone mineral density measurement: an Italian study. J Clin Densitom. 2005; 8(2):199-205. https://doi.org/10.1385/jcd:8:2:199

Richy F, Gourlay M, Ross PD, Sen SS, Radican L, De Ceulaer F, et al. Validation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium. Qjm. 2004 Jan; 97(1):39-46. https://doi.org/10.1093/qjmed/hch002

Rud B, Hilden J, Hyldstrup L, Hrobjartsson A. Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review. Osteoporos Int. 2007 Sep; 18(9):1177-87. https://doi.org/10.1007/s00198-006-0319-3

Cadarette SM, Jaglal SB, Kreiger N, McIsaac WJ, Darlington GA, Tu JV. Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry. Cmaj. 2000 May; 162(9):1289-94.

Ben Sedrine W, Devogelaer JP, Kaufman JM, Goemaere S, Depresseux G, Zegels B, et al. Evaluation of the simple calculated osteoporosis risk estimation (SCORE) in a sample of white women from Belgium. Bone. 2001 Oct; 29(4):374-80. https://doi.org/10.1016/s8756-3282(01)00583-x

Reginster JY, Ben Sedrine W, Viethel P, Micheletti MC, Chevallier T, Audran M. Validation of OSIRIS, a prescreening tool for the identification of women with an increased risk of osteoporosis. Gynecol Endocrinol. 2004 Jan; 18(1):3-8. https://doi.org/10.1080/09513590310001651713

Black DM, Steinbuch M, Palermo L, Dargent-Molina P, Lindsay R, Hoseyni MS, et al. An assessment tool forpredicting fracture risk in postmenopausal women. Osteoporos Int. 2001; 12(7):519-28. https://doi.org/10.1007/s001980170072

Michaelsson K, Bergstrom R, Mallmin H, Holmberg L, Wolk A, Ljunghall S. Screening for osteopenia and osteoporosis: selection by body composition. Osteoporos Int. 1996; 6(2):120-6. https://doi.org/10.1007/bf01623934

Ayers M, Prince M, Ahmadi S, Baran DT. Reconciling quantitative ultrasound of the calcaneus with X-ray-based measurements of the central skeleton. J Bone Miner Res. 2000 Sep; 15(9):1850-5. https://doi.org/10.1359/jbmr.2000.15.9.1850

Stewart A, Reid DM. Quantitative ultrasound in osteoporosis. Semin Musculoskelet Radiol. 2002 Sep;6(3):229-32. https://doi.org/10.1055/s-2002-36720

Nairus J, Ahmadi S, Baker S, Baran D. Quantitative ultrasound: an indicator of osteoporosis in perimenopausal women. J Clin Densitom. 2000; 3(2):141-7. https://doi.org/10.1385/jcd:3:2:141

El Maghraoui A, Do Santos Zounon AA, Jroundi I, Nouijai A, Ghazi M, Achemlal L, et al. Reproducibility of bone mineral density measurements using dual X-ray absorptiometry in daily clinical practice. Osteoporos Int. 2005 Dec; 16(12):1742-8. https://doi.org/10.1007/s00198-005-1916-2

El Maghraoui A, Achemlal L, Bezza A. Monitoring of dual-energy X-ray absorptiometry measurement in clinical practice. J Clin Densitom. Jul-Sep 2006; 9(3):281-6. https://doi.org/10.1016/j.jocd.2006.03.014

El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, et al. Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom. Oct-Dec 2006; 9(4):454-60. https://doi.org/10.1016/j.jocd.2006.07.001

Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994 Nov;4(6):368-81. https://doi.org/10.1007/bf01622200

Kung AW, Ho AY, Sedrine WB, Reginster JY, Ross PD. Comparison of a simple clinical risk index and quantitative bone ultrasound for identifying women at increased risk of osteoporosis. Osteoporos Int. 2003 Sep;14(9):716-21. https://doi.org/10.1007/s00198-003-1428-x

Kim KI, Han IK, Kim H, Cho NH. How reliable is the ultrasound densitometer for community screening to diagnose osteoporosis in spine, femur, and forearm? J Clin Densitom. 2001; 4(2):159-65. https://doi.org/10.1385/jcd:4:2:159

Jorgensen HL, Warming L, Bjarnason NH, Andersen PB, Hassager C. How does quantitative ultrasound compare to dual X-ray absorptiometry at various skeletal sites in relation to the WHO diagnosis categories? Clin Physiol. 2001 Jan; 21(1):51-9. https://doi.org/10.1046/j.1365-2281.2001.00298.x

Njeh CF, Hans D, Li J, Fan B, Fuerst T, He YQ, et al. Comparison of six calcaneal quantitative ultrasound devices: precision and hip fracture discrimination. Osteoporos Int. 2000; 11(12):1051-62. https://doi.org/10.1007/s001980070027

Gudmundsdottir SL, Indridason OS, Franzson L, Sigurdsson G. Age-related decline in bone mass measured by dual-energy X-ray absorptiometry and quantitative ultrasound in a population-based sample of both sexes: identification of useful ultrasound thresholds for osteoporosis screening. J Clin Densitom. 2005; 8(1):80-6. https://doi.org/10.1385/jcd:8:1:080

Marin F, Lopez-Bastida J, Diez-Perez A, Sacristan JA. Bone mineral density referral for dual-energy X-ray absorptiometry using quantitative ultrasound as a prescreening tool in postmenopausal women from the general population: a cost-effectiveness analysis. Calcif Tissue Int. 2004 Mar; 74(3):277-83. https://doi.org/10.1007/s00223-003-0135-0

Frost ML, Blake GM, Fogelman I. Can the WHO criteria for diagnosing osteoporosis be applied to calcaneal quantitative ultrasound? Osteoporos Int. 2000; 11(4):321-30. https://doi.org/10.1007/s001980070121

Pearson D, Masud T, Sahota O, Earnshaw S, Hosking D. A comparison of calcaneal dual-energy X-ray absorptiometry and calcaneal ultrasound for predicting the diagnosis of osteoporosis from hip and spine bone densitometry. J Clin Densitom. 2003; 6(4):345-52. https://doi.org/10.1385/jcd:6:4:345

Damilakis J, Maris TG, Karantanas AH. An update on the assessment of osteoporosis using radiologic techniques. Eur Radiol. 2007 Jun; 17(6):1591-602. https://doi.org/10.1007/s00330-006-0511-z

El-Desouki MI, Sherafzal MS, Othman SA. Comparison of bone mineral density with dual energy x-ray absorptiometry, quantitative ultrasound and single energy x-ray absorptiometry. Saudi Med J. 2005;26(9):1346-50.

Stewart A, Reid DM. Quantitative ultrasound or clinical risk factors--which best identifies women at risk of osteoporosis? Br J Radiol. 2000 Feb; 73(866):165-71. https://doi.org/10.1259/bjr.73.866.10884730

Kraemer DF, Nelson HD, Bauer DC, Helfand M. Economic comparison of diagnostic approaches for evaluating osteoporosis in older women. Osteoporos Int. 2006 Jan; 17(1):68-76. https://doi.org/10.1007/s00198-005-1922-4

Sim MF, Stone M, Johansen A, Evans W. Cost effectiveness analysis of BMD referral for DXA using ultrasound as a selective pre-screen in a group of women with low trauma Colles' fractures. Technol Health Care.2000;8(5):277-84. [Accessed 16 June 2021]. Available From: https://dl.acm.org/doi/abs/10.5555/371695.371740

Panichkul S, Panichkul P, Sritara C, Tamdee D. Costeffectiveness analysis of various screening methods for osteoporosis in perimenopausal Thai women. Gynecol Obstet Invest. 2006; 62(2):89-96. https://doi.org/10.1159/000092803

Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008 Apr; 19(4):385-97. https://doi.org/10.1007/s00198-007-0543-5

Fujiwara S, Nakamura T, Orimo H, Hosoi T, Gorai I, Oden A, et al. Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAX). Osteoporos Int. 2008 Apr;19(4):429-35.https://doi.org/10.1007/s00198-007-0544-4

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2016 Imad Ghozlani et al.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...